The efficacy of oral azithromycin in clearing ocular chlamydia: mathematical modeling from a community-randomized trachoma trial.
The efficacy of oral azithromycin in clearing ocular chlamydia: mathematical modeling from a community-randomized trachoma trial.
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DOI：
10.1016/j.epidem.2013.12.001
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发表时间：
2014-03
期刊：
影响因子：
3.8
通讯作者：
West, Sheila K.
中科院分区：
文献类型：
--
作者：
Liu, Fengchen;Porco, Travis C.;Mkocha, Harran A.;Munoz, Beatriz;Ray, Kathryn J.;Bailey, Robin L.;Lietman, Thomas M.;West, Sheila K.
大规模口服阿奇霉素的分发极大地降低了导致沙眼的眼部衣原体菌株的患病率。评估抗生素对个体的疗效对于制定沙眼消除计划非常重要。然而，疗效很难估计，因为治疗后的实验室检测可能因非存活微生物或再感染而变得复杂。作为坦桑尼亚整群随机临床试验的一部分，我们每年两次监测 32 个社区学龄前儿童的眼部衣原体感染情况（经过 3 年的年度治疗后，儿童患病率从 22.0% 降至 4.7%）。我们使用数学传播模型来估计治疗后立即感染的患病率，发现在此情况下抗生素对个体的有效现场疗效为 67.6%（95% CI：56.5-75.1%）。敏感性分析表明，这些结果并不依赖于有关感染持续时间的具体假设。我们在试验过程中没有发现疗效下降的证据。我们估计，经过 10 年的年度治疗和 95% 的覆盖率后，消除的可能性为 89%。
Mass oral azithromycin distributions have dramatically reduced the prevalence of the ocular strains of chlamydia that cause trachoma. Assessing efficacy of the antibiotic in an individual is important in planning trachoma elimination. However, the efficacy is difficult to estimate, because post-treatment laboratory testing may be complicated by nonviable organisms or reinfection. Here, we monitored ocular chlamydial infection twice a year in pre-school children in 32 communities as part of a cluster-randomized clinical trial in Tanzania (prevalence in children was lowered from 22.0% to 4.7% after 3-year of annual treatment). We used a mathematical transmission model to estimate the prevalence of infection immediately after treatment, and found the effective field efficacy of antibiotic in an individual to be 67.6% (95% CI: 56.5–75.1%) in this setting. Sensitivity analyses suggested that these results were not dependent on specific assumptions about the duration of infection. We found no evidence of decreased efficacy during the course of the trial. We estimated an 89% chance of elimination after 10 years of annual treatment with 95% coverage.
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影响因子：
3.8
作者：
Burton, Matthew J.;Holland, Martin J.;Bailey, Robin L.
通讯作者：
Bailey, Robin L.
影响因子：
120.7
作者：
Chidambaram, JD;Alemayehu, W;Lietman, TM
通讯作者：
Lietman, TM
冈比亚和坦桑尼亚的沙眼患病率和相关危险因素：整群随机对照试验的基线结果。
影响因子：
3.8
作者：
Harding-Esch, Emma M.;Edwards, Tansy;Mkocha, Harran;Munoz, Beatriz;Holland, Martin J.;Burr, Sarah E.;Sillah, Ansumana;Gaydos, Charlotte A.;Stare, Dianne;Mabey, David C. W.;Bailey, Robin L.;West, Sheila K.
通讯作者：
West, Sheila K.
影响因子：
168.9
作者：
Gebre, Teshome;Ayele, Berhan;Gaynor, Bruce D.
通讯作者：
Gaynor, Bruce D.
影响因子：
3.8
作者：
Lietman, Thomas M.;Gebre, Teshome;Ayele, Berhan;Ray, Kathryn J.;Maher, M. Cyrus;See, Craig W.;Emerson, Paul M.;Porco, Travis C.
通讯作者：
Porco, Travis C.